Abstract
This retrospective study is looking into the long-term morbidity after endometrial cancer staging surgery and compares the long-term morbidity of patients who underwent open staging surgery vs. robotic approach. One hundred twenty-nine patients who underwent staging surgery for endometrial cancer from January 2014 until June 2017 were included in the analysis. Morbidities occurring 1 month after surgery—vault complications, incisional hernias, vault dehiscence, and lymphedema—were looked into. There were no statistically significant differences between the long-term complications in both groups (vault infection 5.1% vs. 1.4%, vaginal cuff dehiscence 1.6% vs. 0%, incisional hernia 6.8% vs. 0%, and lymphedema 11.8% vs. 10% in open vs robotic groups respectively). But as far as clinical significance was concerned, patients who underwent robotic staging surgery had a significant decrease in vaginal cuff complications and incisional hernia. Our study shows that robotic-assisted surgery can reduce even long-term morbidity in patients undergoing surgery for endometrial cancer.
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References
Maheshwari A, Kumar N, Mahantshetty U (2016) Gynecological cancers: a summary of published Indian data. South Asian J Cancer 5(3):112–120
Balasubramaniam G, Sushama S, Rasika B, Mahantshetty U (2013) Hospital-based study of endometrial cancer survival in Mumbai, India. Asian Pac J Cancer Prev 14(2):977–980
(2018) The burden of cancers and their variations across the states of India: the Global Burden of Disease Study 1990-2016.India State-Level Disease Burden Initiative Cancer Collaborators. Lancet Oncol 19(10):1289–1306. https://doi.org/10.1016/S1470-2045(18)30447-9
Walker JL, Piedmonte MR, Spirtos NM, Eisenkop SM, Schlaerth JB, Mannel RS, Spiegel G, Barakat R, Pearl ML, Sharma SK (2009) Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group Study LAP2. J Clin Oncol 27(32):5331–5336
Walker JL, Piedmonte MR, Spirtos NM et al (2012) Recurrence and survival after random assignment to laparoscopy versus laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group LAP2 Study. J Clin Oncol 30(7):695–700
Agarwal R, Rajanbabu A, Goel G, Unnikrishnan UG (2018) A comparison of the clinical outcomes in uterine cancer surgery after the introduction of robotic-assisted surgery. J Obstet Gynecol India. https://doi.org/10.1007/s13224-018-1170-0
Lim PC, Kang E, Park DH (2011) A comparative detail analysis of the learning curve and surgical outcome for robotic hysterectomy with lymphadenectomy versus laparoscopic hysterectomy with lymphadenectomy in treatment of endometrial cancer: a case-matched controlled study of the first one hundred twenty two patients. Gynecol Oncol 120(3):413–418. https://doi.org/10.1016/j.ygyno.2010.11.034
Rossi EC, Kowalski LD, Scalici J, Cantrell L, Schuler K, Hanna RK (2017) A comparison of sentinel lymph node biopsy to lymphadenectomy for endometrial cancer staging (FIRES trial): a multicentre, prospective, cohort study. Lancet Oncol 18(3):384–392. https://doi.org/10.1016/S1470-2045(17)30068-2
Rajanbabu A, Murali V, Nataraj YS, Vijaykumar DK (2015) Detection of sentinel lymph nodes in endometrial cancer with intracervical indocyanine green injection and robotically assisted near infrared imaging: a feasibility study in Indian setting. Indian J Gynecol Oncol 13(1):1–6. https://doi.org/10.1007/s40944-015-0020-6
Rajanbabu A, Agarwal R (2018) A prospective evaluation of the sentinel node mapping algorithm in endometrial cancer and correlation of its performance against endometrial cancer risk subtypes. Eur J Obstet Gynecol Reprod Biol 224:77–80
Persson J, Reynisson P, Borgfeldt C, Kannisto P, Lindahl B, Bossmar T (2009) Robot assisted laparoscopic radical hysterectomy and pelvic lymphadenectomy with short and long term morbidity data. Gynecol Oncol 113(2):185–190. https://doi.org/10.1016/j.ygyno.2009.01.022
Bell MC, Torgerson J, Seshadri-Kreaden U, Suttle AW, Hunt S (2008) Comparison of outcomes and cost for endometrial cancer staging via traditional laparotomy, standard laparoscopy and robotic techniques. Gynecol Oncol 111(3):407–411. https://doi.org/10.1016/j.ygyno.2008.08.022
Hopp EE, Osborne JL, Schneider DK, Bojar CJ, Uyar DS (2015) A prospective pilot study on the incidence of post-operative lymphedema in women with endometrial cancer. Gynecol Oncol Rep 15:25–28. Published 2015 Dec 24. https://doi.org/10.1016/j.gore.2015.12.002
Kuoppala T, Tomás E, Heinonen PK (2004) Clinical outcome and complications of laparoscopic surgery compared with traditional surgery in women with endometrial cancer. Arch Gynecol Obstet 270:25. https://doi.org/10.1007/s00404-003-0488-7
Fuchs Weizman N, Einarsson JI, Wang KC, Vitonis AF, Cohen SL (2015) Vaginal cuff dehiscence: risk factors and associated morbidities. JSLS. 19(2):e2013.00351
Bush SH, Apte SM (2015) Robotic-assisted surgery in gynecological oncology. Cancer Control:307–313. https://doi.org/10.1177/107327481502200308
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Padmanabhan, D.S., Anumolu, A., Pranav, S.M. et al. Long-Term Morbidity after Endometrial Cancer Surgery: a Comparison of Open vs. Robotic Approach. Indian J Surg Oncol 10, 292–295 (2019). https://doi.org/10.1007/s13193-019-00906-9
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DOI: https://doi.org/10.1007/s13193-019-00906-9